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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407152
Report Date: 03/24/2022
Date Signed: 03/24/2022 02:29:42 PM


Document Has Been Signed on 03/24/2022 02:29 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:KNIGHT, TORI FAMILY CHILD CARE HOMEFACILITY NUMBER:
045407152
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
03/24/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Tori KnightTIME COMPLETED:
02:35 PM
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Licensing Program Analyst, Emilia Grisak conducted a case management facility inspection on 3/24/22 at 1:55pm. This inspection was in response to an application for increased capacity that was received by the Department on 2/7/2022. The licensee has requested a capacity increase to 14 children.

The LPA toured the facility's indoor and outdoor areas. The off-limits areas of the home are the garage, all bedrooms and a linen closet which has been made inaccessible using door knob covers. The children use the back yard as the outdoor play area and it is fully fenced. There is a hot tub on the back deck that is covered and locked as required. The LPA reviewed the ratio's for a large license and the licensee acknowledged she understood the ratio requirements. The LPA also reviewed the Safe Sleep requirements with provider. Provider has a full time assistant and has required forms for assistant.



Licensee's CPR/First Aid was completed and expires on 3/2022. Licensee and assistant are both scheduled to complete CPR/First Aid on 3/27/22. Based on the space/accommodations available at this facility and the fire marshal granting their approval on 3/22/22 for the 14 children, the capacity increase request is granted. LPA will process this capacity increase and mail an updated license to reflect this capacity change to 14 children. An exit interview was conducted with licensee.

Notice of Site Visit was given to licensee to post for 30 days.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia GrisakTELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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